Lin Chieh-Chung, Chan Shu-Yen, Lin Wei-Szu, Wu Meng-Che, Polpichai Natchaya, Lin Chien-Heng, Wei James Cheng-Chung
Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung, 40201, Taiwan.
Pediatric Gastroenterology, Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Dig Dis Sci. 2025 Apr 25. doi: 10.1007/s10620-025-08957-5.
Biliary atresia (BA) is a serious pediatric liver disease and the leading cause of liver transplants in children. Although its cause is unknown, prior research suggests air pollution may influence childhood diseases. This study examines the potential association between prenatal air pollution exposure and BA incidence.
This nationwide, longitudinal matched case-control study used data from the National Health Insurance Research Database in Taiwan. BA cases were identified using ICD codes in children who underwent the Kasai procedure or liver transplantation. Controls, matched by age, index month, and gender, were selected at a 1:10 ratio. Multivariable logistic regression models, adjusted for potential confounders (age, gender, maternal age, delivery mode, and preterm birth), were utilized to assess the association between individual air pollutants (PSI, SO, CO, O, PM, PM, NO, NO, and NO) and BA. Quartiles of cumulative air pollutant amounts were analyzed for dose-dependent effects.
A total of 1,663,737 first-time pregnancies were identified from 2004 to 2016. After excluding 8,523 newborns due to congenital neonatal defects, 1,655,214 individuals remained. Among them, a cohort of 253 BA patients was identified. After adjusting for multiple confounders, no significant associations were found between prenatal exposure to air pollutants and BA risk. Quartile analysis of cumulative air pollutant exposure also indicated no dose-response relationship with BA risk for each air pollutant.
This population-based study found no statistically significant association between prenatal air pollution exposure and the risk of BA in newborns in Taiwan.
胆道闭锁（BA）是一种严重的儿科肝脏疾病，也是儿童肝移植的主要原因。尽管其病因不明，但先前的研究表明空气污染可能会影响儿童疾病。本研究探讨产前空气污染暴露与BA发病率之间的潜在关联。
这项全国性的纵向匹配病例对照研究使用了台湾国民健康保险研究数据库的数据。通过接受葛西手术或肝移植的儿童的国际疾病分类代码来确定BA病例。按照年龄、索引月份和性别以1:10的比例选择对照。利用多变量逻辑回归模型，并对潜在混杂因素（年龄、性别、母亲年龄、分娩方式和早产）进行调整，以评估个体空气污染物（PSI、SO、CO、O、PM、PM、NO、NO和NO）与BA之间的关联。分析累积空气污染物量的四分位数以研究剂量依赖效应。
2004年至2016年共确定了1,663,737例首次怀孕。排除8,523例因先天性新生儿缺陷的新生儿后，剩余1,655,214人。其中，确定了253例BA患者的队列。在调整多个混杂因素后，未发现产前暴露于空气污染物与BA风险之间存在显著关联。累积空气污染物暴露的四分位数分析也表明，每种空气污染物与BA风险之间均无剂量反应关系。
这项基于人群的研究发现，台湾新生儿产前空气污染暴露与BA风险之间在统计学上无显著关联。
